The tool used by psychiatrists to determine which patients are in immediate danger of suicide is ineffective and meaningless, according to an analysis of studies spanning half a century.
University of NSW Professor Matthew Large and University of Sydney Associate Professor Chris Ryan have called for risk assessment guidelines to be thrown out as a means by which to allocate resources to mental health patients as reported by the SMH.
Patients who were categorised “high risk” were 4.84 times more likely to suicide than those categorised “low risk” – which was statistically significant but clinically meaningless, as it was only slightly higher than the odds of men suiciding than women.
About 95 per cent of high-risk patients did not commit suicide, while half of low-risk patients did.
“The statistical difference is not big enough to mean anything,” Associate Professor Ryan said.
“If clinicians keep on doing these sorts of risk assessments, they’re really doing something that can’t possibly help them in the management of that patient and might mislead them.”
The meta-analysis of 37 studies on the link between suicide classification and mortality, published in PLOS One, found there was no reliable way to measure suicide risk and no scientific progress had been made in 50 years.
Complex methods of risk assessment that took into account multiple factors were not superior to those which measured a single risk factor.
Risk assessment guidelines are used to categorise mental health patients, with those deemed to be at high risk of suicide admitted to hospital and those believed to be at low risk sent home.
They take into account factors such as previous suicide attempts, substance abuse, depression age, employment status and family situation.
Professor Large said the consequences of relying on the risk assessment tool over an individual approach to patients could be that people deemed “low risk” were sent home to die, or those deemed “high risk” were unnecessarily committed.
Six of the most senior emergency department psychiatrists in NSW, including himself, had already stopped using the risk assessment guidelines, Professor Large said.
“We all agreed risk categorisation was a disaster.”
In Tasmania, reference to risk assessment has been removed from the Mental Health Act. To read more CLICK HERE.
Suicide will be a topic of discussion at The 17th International Mental Health Conference; Guiding the Change to be held at the brand new Sea World Resort Conference Centre on the Gold Coast, QLD from the 11 -12 August 2016.
This conference will bring together leading clinical practitioners, academics, service providers and mental health experts to deliberate and discuss Mental Health issues confronting Australia and New Zealand.
The conference program will be designed to challenge, inspire, demonstrate and encourage participants while facilitating discussion. To register your attendance at the conference CLICK HERE.